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Sciatic Nerve Pain or Sciatica is a general condition in which the sciatic nerve has become inflamed and painful. The pain is generally described as the sensation of a burning hot poker going down the back of the leg. I have seen the pain shoot just a short distance into the upper thigh area or all the way down the leg to the foot. The sciatic nerve originates from the lumbar spine at levels L2 down to L5 and from the first sacral segment. This nerve, generally the size of your little finger, carries nerve impulses that go to and come from the lower leg and foot. Therefore, with sciatic pain, one might experience numbness, weakness, or pain in the lower leg and foot that may seem disconnected from the actual nerve pain in the upper back part of the leg.

In order to understand how to relieve sciatic pain, you need to understand where the pain is actually coming from. There are several sources of impingement that can cause the sciatic type of pain complex. The first and most hazardous is a space occupying lesion like a disc bulge or herniation of the disc. A space occupying lesion in the lumbar neural canal can also be a secondary cancerous tumor. Both of these possibilities need to be considered when dealing with sciatic pain. Another possibility is what has been called pseudo sciatica. This condition stems from the hip rotator muscles, primarily the piriformis muscle. The sciatic nerve frequently will travel through the muscle belly of the piriformis muscle and if the muscle develops a trigger point or goes into a state of long term spasm, it can inflame the sciatic nerve. This is an easier condition to work with, but is no less painful for the patient.

Relieving the pain should begin with an examination by a physician trained in neuromuscular pain syndromes. A neurologist or orthopedist can easily order the tests (MRI) to diagnose the presence of a space occupying lesion like a disc bulge or tumor. The chiropractic physician is also highly adept at identification of these types of lesions and working with the spinal joints to relieve the pressure on a disc or the trigger point in the hip rotator muscles. Occasionally your medical doctor will prescribe muscle relaxers and pain medications that can help relieve the spasm in the muscles and the pain symptoms until the body heals the condition on its own. Home remedies can include ice for inflammation in the area of the lower back (also a space occupying lesion), heat on the buttock on the side of the pain to relieve muscle spasm of the hip rotator muscles, massage of the muscles of the lower back or buttocks on the side of pain, or specific stretching exercises to decrease the spasms.

Sciatic Nerve pain can be extremely painful and debilitating. If you are trying to relieve it with home remedies, give them a try and if they don’t give you results within a day, you need to consult a physician to make sure that the pain is not a symptom of a more serious problem. It has been said that this condition will frequently resolve on its own without treatment in four to six weeks, but can you wait that long to get relief? Most chiropractors and orthopedic surgeons will look for the underlying source of the problem and not simply allow an adaptation of the body to bypass the damage that is done. Pain is present for a reason; please consult someone who can help you resolve the cause.

A herniated disc and a bulging disc are very similar or the same on some levels and on other levels, they can be completely different.

A disc bulge can be thought of as an inflamed disc that has a broader based outward expansion from its normal state. As the annulus pushes outward, contact and subsequent inflammation can occur in any nerves, spinal cord, or bony structures the disc comes in contact with. As this inflammation spreads, the pain from the disc bulge begins to include the nerves transmitting that pain to the brain.

A herniation is more of a canal that goes through the outer disc material which allows the nucleus of the disc to extrude through the canal and push against structures in the spine. The same result happens, depending on what structures are contacted and the degree of inflammation caused by the injury.

The resulting pain is diagnosed as a radiculopathy and have a prevalence of 35% of men and 45% of women having these at some point in their lifetime.

These disc events happen most often as a result of repetitive flexion events to the lower back at the disc level. One study (Adams & Hutton et al, Spine 1982) suggests that 28,000 repetitions of flexion are required to herniate a disc. If there is compression on the disc with flexion, fewer cycles are required to herniate a disc. So bending forward at the waist over a life time can cause this bulging.

There are levels of herniation that can happen. The worst being the sequestered disc herniation where the nuclear material pushes out of the disc and separates from the disc to become a free floating mass in the lower back. The only response to this condition is a surgical removal of the disc material. The most frequent type of herniation is where the disc material remains attached and in this case, taking the pressure off the disc (through adjusting or traction) will allow that material to be drawn back into its normal position where it will likely scar over and become stable over time. During this process it is imperative that the inflammatory process be reduced so healing can take place. Disc pain is generally characterized as a pain that goes from the lower back into the extremity as a result of involving neurology in some way. Occasionally a disc can be painful in and of itself, in which case it will feel like a deep localized sharp pain which is more intense in flexion and relieved by extension.

This is a fairly simplified look at disc herniation and the only true way to determine disc herniation is via advanced imaging techniques like MRI. Check with your doctor for advice on how to proceed with your lower back pain. Your chiropractic doctor works with these conditions daily and will be able to help you determine the next course of action.